Brachial Plexus Block with Bupivacaine Hydrochloride / 대한마취과학회지

General anesthesia has been improved technically and applied in a wide field of surgery, but the undesirable side effects of inhalational anesthetics and its adjuvants such as muscle relxants have frequently claimed our attention in current anesthetic practice. For these reasons, various techniques of brachial plexus block have been developed for the purpose of surgical, diagnostic and therapeutic procedures. The short duration of local anesthetics requires repeated drug administration for a long lasting operation, therefore drug overdosage may cause toxic reaction. Recently introduced bupivacaine hydrochloride(Marcain), an anilide derivative, has longer duration of action and higher potency than other local anesthetics. Brachial plexus block with bupivacaine hydrochloride and lidocaine was performed on 166 patients undertaking various surgical operations for upper extremities at the Department of Anesthesiology, Pusan National University Hospital form October, 1981 to Mary, 1982, the results were summarized as follows: 1) 156 cases of a total 166 patients had successful operations under brachial plexus block but remained the remaining 10 cases required general anesthesia. 2) There were 9 cases of pulmonary diseases, 17 cardiovascular diseases and 2 nephritis in the preoperative evaluation of the patients. 3) The average duration of analgesia for lidocaine and bupivacaine hydrochloride group was 180 and 360 minutes respectively. 4) Complications and side reaction of brachial plexus block included 3 cases of pneumothorax, 15 Horner's syndrome, 2 hematoma formation and 1 toxic sign.

The Clinical Study of Liver function in Operative Patients / 대한마취과학회지

Since ether was first introduced in Boston in 1846, many kinds of anesthetic techniques and agents have been developed. At the same time, there have been many controversies about the side effects following the use of anesthetic agents and they are studied actively by many investigators at the present time. The author chose 355 patients randomly who had received elective operation at the Pusan National University Hospital from October 1980 to March 1981 and made a study of their preand post-operative liver function test. The patients were divided into 3 groups and 214 the patients belonging to group l were anesthetized with general anesthesia and group 2 comprising 118 patients had spinal anesthesia and brachial plexus block was used in the group 3 of 23 patients. The results obtained were as follows: 1) The male to female ratio was about 3 to 2 (209 cases: 146 cases) and age distribution showed a range from 20 to 50 years(210 cases). 2) Pre-operative liver function test of group 1,2, and 3 proved to be abnormal in 75 cases, 23 cases, 6 cases respectively. 3) In patients of group 1, halothane alone(54 cases) and halothane with nitrous oxide(111 cases) were the most commonly used anesthetics. 4) Post-operative checkup of liver function test of 10 patients who were randomly selected from each group and who had previously had normal liver functions, 4 cases of group 1 turned out to be abnormal, but patients in group 2, and 3 showed no significant abnormality in the post-operative liver function test. 5) Anesthesia aggravated liver dysfunction of the patients of group l who had abnormal liver function prior to operation, but it returned to the pre-operative level within 10 days after operation.

Airway Obstruction due to Mucous Plug after Endotracheal Intubation in Comatous Patient / 대한마취과학회지

This a case report of airway obstruction due to mucous plug which occurred. as a complication of endotracheal intubation. This 16-year old patient was performed on endotracheal intubation for cardio-pulmonary resuscitation of cardiac arrest due to traume. He was comatous, tachypneic and increased pulse rate at 6 hours after intubation, then we found the uneven ventilation of both lung fields. We exchanged endotracheal tube after failure of suction and found airway obstruction due to mucous plug. After exchange of tube, suction of secretion and trachecstomy was performed. 3 days afterward, the patient was recovered from his poor pulmonary function, then transferred to the ward.